Renal Pigmentation Due to Chronic Bismuth Administration in a Rhesus Macaque (Macaca mulatta)

• Published in: Veterinary pathology Vol. 52; no. 3; pp. 576 - 579
• Main Authors: Johnson, A. L., Blaine, E. T., Lewis, A. D.
• Format: Journal Article
• Language: English
• Published: Los Angeles, CA SAGE Publications 01.05.2015
• Subjects: Animals; Antiemetics - adverse effects; Antiemetics - therapeutic use; Bismuth - adverse effects; Bismuth - therapeutic use; Kidney - drug effects; Kidney - pathology; Kidney Diseases - chemically induced; Kidney Diseases - pathology; Kidney Diseases - veterinary; Macaca mulatta; Male; Monkey Diseases - chemically induced; Monkey Diseases - pathology; Organometallic Compounds - adverse effects; Organometallic Compounds - therapeutic use; Pigmentation - drug effects; Pigmentation Disorders - chemically induced; Pigmentation Disorders - pathology; Pigmentation Disorders - veterinary; Salicylates - adverse effects; Salicylates - therapeutic use; Vomiting - drug therapy; Vomiting - veterinary; intranuclear inclusion bodies; pigment; Macaca mulatta; kidney tubules; renal tubular epithelium; bismuth
• ISSN: 0300-9858; 1544-2217
• DOI: 10.1177/0300985814541707

Renal pigmentation due to the administration of exogenous compounds is an uncommon finding in most species. This report describes renal pigmentation and intranuclear inclusions of the proximal convoluted tubules due to chronic bismuth administration in a rhesus macaque. An 11-year-old Indian-origin rhesus macaque with a medical history of chronic intermittent vomiting had been treated with bismuth subsalicylate, famotidine, and omeprazole singly or in combination over the course of 8 years. At necropsy, the renal cortices were diffusely dark green to black. Light and electron microscopy revealed intranuclear inclusions within the majority of renal proximal tubular epithelial cells. These inclusions appeared magenta to brown when stained with hematoxylin and eosin and were negative by the Ziehl-Neelsen acid-fast stain. Elemental analysis performed on frozen kidney measured bismuth levels to be markedly elevated at 110.6 ppm, approximately 500 to 1000 times acceptable limits. To our knowledge, this is the first report of renal bismuth deposition in a rhesus macaque resulting in renal pigmentation and intranuclear inclusions.